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3 Arrythm
Arrythmias
39
Biochemistry
Graduate
11/05/2017

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Term
Warfarin Dose shud be decreased w/ RXs
Definition
[AASS]
-Amiodarone
-Azoles
-Statins
-Septra
Term
Warfarin monitoring = q _____wks
Definition
q 12 wks (recheck in 5 days w/ dose changes)

(metab influenced by VKORC1,Cyp2C9,3A4 genetics)
Term
Warfarin + ASA indicated in
Definition
-S/P ACS
-Mechanical Hrt Valve
(inc bleeding risk)
Term
Warfarin alone better than aspirin alone for
Definition
MI prevention
Term
Vegetarians have inc intake of
Definition
Vitamin K----a clotting factor
Term
When WARFARIN to DOAC???
Definition
INR less than 2
INR 2-2.5 (strt next day)

{Xarelto strt when INR<3}
Term
HEPARIN to DOAC WHEN????
Definition
-2 hrs after dicont hep
Term
LMWH to DOAC WHEN????
Definition
when next LMWH dose is due
Term
DOAC to WARFARIN WHEN????

DOAC to LMWH WHEN????
Definition
DOAC to WARFARIN WHEN????
DOAC taken simultaneous till INR range reached (bridging)

DOAC to LMWH WHEN????
when nxt dose of DOAC due
Term
Low risk bleeding

HIGH RISK BLEEDING
Definition
Hold DOAC 24 hrs prior w/ LOW

_HOLD DOAC 48 hrs prior w/HIGH
Term
These Risks are
Cath ablation/electro study
Endoscopy w/biopsy
prostate/bladder biopsy
Angiography
Pacemaker/ICD implant(unless CHD)
Definition
LOW RISKS
Term
These Risks are
Complex left sided ablation
spinal/epidural anasthesia
thoracic,ab,or major orthoped surgery
Liver/Kidney biopsy
Definition
HIGH RISKS
Term
Signs and symptoms of bleed
HCT=
Platelet=
Definition
HCT= <30%
Platelet=<100,000 or 50% below baseline
New back,flank, groin pain
Melena,etc
Term
Heparin BASELINE Monitor
Definition
CBC
Pt/INR and PTT, Weight/Height
Term
HEPARIN ongoing monitor CBC q
anti Xa
Definition
CBC check= q 1 to 3 days

anti Xa= 6 to 8 hrs after bolus and initial infusion/dose change til therapeutic(once daily therafter)
Term
LMWH be careful with _____dosing
Definition
Renal
(Enoxaparin<30ml/min reduce dose)
Term
LMWH BASELINE Monitor
Definition
CBC
Pt/INR and PTT, Weight/Height
Basic metabol panel
Term
LMWH ongoing monitor CBC q
anti Xa
Definition
CBC= 1st 14 days
(q 1-2 days in pt.2-7 days out pt)

Bone density in tx >3mnths
(AntiXa=indicated pops)
Term
DO NOT USE THIS LMWH IN CrCl <30mL/min
Definition
FONDAPARINUX (ARIXTRA)
Term
Class 1A
Definition
Quinidine, procainamide
-Na+ blockers
Term
Class 1B
Definition
Lidocaine, Mexiletine
-Na+ blockers
-Slows conduction Velocity/inc recov period
Term
Class 1C
Definition
Flecanaide, Propafenone
-Na+ blockers
-SLow conduc velocity/inc recov period
Term
Class II
Definition
Metoprolol, Atenolol
-Beta Blockers
Term
Class III
Definition
Dofetilide, Amiodarone,Dronedarone, Sotalol, Ibutilide
-K+ Blockers [prolongs refrac period/delays repolarization]
Term
Class IV
Definition
Verapamil, DILTIAZEM
-CCBs
[prolong repolztn at AV node,dec cond velocity]
Term
Other Anti Arythmics RXs
Definition
Digoxin, Mg2+, Adenosine
-Miscellaneous
Term
Lidocaine (Xylocaine) Indication
Definition
VF
VT
Term
LIDOCAINE MONITOR
Definition
K & Mg
Serumlidocaine (2-6ug/ml)
Term
Flecanaide (Tambacor) Indication
Definition
AF
VT
PSVT
Term
Flecanaide Monitor
Definition
ECG
K & Mg
SCr
Serum rx conc (0.2-1mcg/mL)
Term
Amiodarone (CORDARONE) Indication
Definition
AF VT VF
Term
Amiodarone Monitor
Definition
ECG
CXR
LFTs
EYE
Term
SOTALOL (Betapace) Indication
Definition
AF VT
Term
SOTALOL Monitor
Definition
ECG, Renal func, K & Mg
Term
Dofetilide (Tikosyn) indication
Definition
AF
[monitor ECG,Renal func, K&Mg]
Term
Dronedarone (Multaq) indication/monitr\
[Take w/ food]
Definition
Paroxysmal AF

Monitor---ECG,LFTs, MG & K+
Term
Diltiazem (Cardizem) &Verapamil (CALAN) indication/monitr
Definition
AF PSVT

MONITR ECG, LFTs
Term
Digoxin (Lanoxin)
Definition
AF

Monitor ECG,K&Mg,renal func
trough Digoxin levels 0.5-2ng/mL
Term
Beta Blockers indication
Definition
AF,VT,PSVT
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